thinking out loud

there were a couple of things i was worried about once i graduated and passed boards.
first thing was accepting the position in the unit where i currently work and how the people there would treat me and see me in this 'new' role.

having worked as an extern on the floor for awhile and then in the icu for even longer (which i love the icu, no secret there), i saw things and took note to things that happened between people, how nurses were, and such. i didn't forget these things. and i TRY my best to have kept my self promise to never do these things. but for me, the treatment hasn't always been the best. for those to whom i was basically an equal for a good amount of time, it seems that they have a hard time accepting me in the role of rn. for some reason, they expect me to do all of my job and some of theirs too. i don't get it. when i clock in, i do my job. i do what it is expected of me. why can't these people do their job? maybe it is just the dayshift people.. i don't know? one thing i do know is that there is so much more teamwork on nights. period. days.. not so much. people are so afraid they might have to do more than someone else. it's crazy. is it so hard to do your job? as a dayshift nurse, i have a hundred meds to pass out at 9 am, along with doing assessments and hopefully finding time to chart. is it necessary for me to also feed a patient or change a bed while you sit on your ass at the nurse's station, talking? it's so frustrating. mostly because patient care comes first for me. i wish i had the time to sit down and chit chat. and then if i ask you to please help.. don't give me the evil eye. sure, i did your job for almost 2 years, and yes, i can still do it, but unfortunately at this moment you cannot do my job. and it is now my job to make sure you do your job. if you did your job, i wouldn't have to ask you to do it.

which leads me to the other problem. three months in and the burn out is beginning. many, many days i so wish i would have just taken the nights position. people on nightshift are just a different breed of people. they are more laid back. you can actually joke with them without them taking anything personal. life goes on. sure you may get frustrated and mad at times, but you are still a team. period. on days, it is sink or swim. sometimes i feel as though i just tread water all day long. just the other day, have to work 12 hours. come 3 pm, we have 3 nurses for 20 patients. i am told that in addition to my 5 existing patients, one who will be arriving any minute from the ed, and potentially 3 discharges in that group, that i need to pick up 2 more patients, one of which is a potential discharge. md's haven't yet made rounds. i told the charge nurse that i 'can't' do 7 patients. note i said can't, not won't. i have 3 months experience, but she thinks that i can take care of all of this shit. are any of the dc orders done? hell no. when another nurse stands up for me, the charge nurse states that i should be able to take care of all of these patients. then she promptly runs into the manager's office to "tell on me." in the meantime, i get report on these 2 extra patients, only to find out a few minutes later, the manager suddenly decides she will come out and be charge for the next 4 hours, freeing up the oncoming charge nurse to take a group. leaving charge nurse seems pissed, tells me i don't have to take the new patients, and goes home. essentially, i finish the 3 discharges as timely as i could [meaning waiting for md rounds and orders] all the while with a family member staring at me, giving me their own version of the evil eye for 2 hours! as if i can control when the md makes rounds, writes orders, and then prioritizing the discharges and other stuff i have to do to make sure my patients get safe care. staring at me does not make me work faster. it just makes me mad. to top that off, the patient storms down the hall, and yells at me for not getting that dc done fast enough. oops, there went the press-ganey score for that patient. hope the manager doesn't call that one tomorrow. in all, we completed 9 discharges for the floor and 5 admissions in those 4 hours of hell. but damn, it's days like that that really make me regret the fact that i didn't shop around other hospitals for a job. i am not saying that it is any better anywhere else, but i didn't even look, and that makes me sad inside.

is it too soon to need a vacation already? well, i try not to take the job home with me. and not all days are like this, but many days are. unfortunately, in a tele unit, we have a high turnover of patients. that's just standard. 99% of chest pains are admitted, whether it is real chest pain or not. many are sent home the next day with negative work ups and negative rhythm changes. but once those rooms are empty, the er typically has another to fill its spot. and this time of year is supposed to be our 'lull' time. hasn't happened this summer. we have been rocking and rolling all summer long. makes for good paychecks and ot opportunities. doesn't help with the day to day doldrums though.

on that note, i am off to bed so that i can do it all over again tomorrow. wonder who i can make mad? oh and my biggest gripe of all... taking care out of our hands and turning the hospitals into hotels. all to look good on a survey which asks questions about matters completely out of our control. can i control how old the furniture in the room is? nope. can i control how the food tastes? nope. can i control the fact that the walls aren't thick enough to block out the noise of the confused patient next door who hollers all night long because they don't know any better? nope. that, however, is a different topic for a different time.